| NPI | 1508956483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26228) |
| Additional Taxonomies | 122300000X Dentist (Licence: NH 3409) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2011-12-08 |